DenialIntel

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Denials›TIMELY_FILING›claim B03M000539

Denial · CARC 29

TIMELY_FILING · MERIDIAN HEALTH PLAN

Denied
552.00
Withheld
Recoverable
0.00
Realistically collectable
Net of rework
0.00
less 31.00
Appeal window
closed 514d ago
Closed

Classification

FieldValue
Primary CARC29
All CARCs29
Root causeTIMELY_FILING
Owns the fixBilling Related
Appealableyes
Recoverableno
Recommended actionFiling limit expired. Rarely recoverable; fix the charge lag upstream.
PayerMERIDIAN HEALTH PLAN
Denial date26 Jan 2025
Appeal deadline26 Apr 2025

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

What should I investigate, and how urgent is it?

The modelled appeal window passed 514 days ago

The 835 reports CARC 29 on 26 Jan 2025, withholding $552.00 from the provider. Modelled recoverable $0.00, less an estimated rework cost of $31.00, leaves $0.00 net. The configured appeal window for this payer ends 26 Apr 2025, 514 days ago. Recommended action: Filing limit expired. Rarely recoverable; fix the charge lag upstream. Confirm the contractual deadline and any exception, reconsideration or correction route with the payer before closing the case.

From: Denial derivation: root cause, appealability, the recoverable amount net of an estimated rework cost, and a filing deadline derived from the denial date.

Limits: The deadline and the recoverable amount are application estimates. The deadline is the denial date plus a configured per-payer window, not a term read from the payer's contract or an appeal notice, and the recoverable figure is a model rather than a promise of payment. Confirm both against the policy before relying on them.

Adjustments

LevelCodeAmountCounts as
linePI/29552.00withheld